Individual provider Active NPI

Roberto Olivarez Jr., O.D.

  • Optometrist
  • McAllen, TX
National Provider Identifier
1144395302
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3517 TG Issued in TX
Practice address
6900 N 10TH St
Suite 5
McAllen, TX 78504-3198
Phone
(956) 664-0240
Fax
(956) 664-0185
NPI assigned
Nov 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3517 TG TX Primary

Addresses

Primary practice location

6900 N 10TH St
Suite 5
McAllen, TX 78504-3198

Mailing address

6900 N 10TH St
Suite 5
McAllen, TX 78504-3198
Phone (956) 664-0240

Other identifiers 1

IdentifierTypeStateIssuer
093559503MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121004000065 TX Practitioner - OptometryPractitioner - Other (Physician) 4284883414 Practice locations: McAllen, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6900 N 10TH St
Suite 5
McAllen, TX 78504-3151
Phone (956) 664-0240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3517 TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Roberto Olivarez Optometrist Optometrist CurrentSince Sep 1, 2012 Accepting new patients

Locations

6900 N 10th St
Ste 5
McAllen, TX 78504
Phone (956) 664-0240

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144395302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 N 10TH ST",
            "address_2": "SUITE 5",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785043198",
            "telephone_number": "956-664-0240",
            "fax_number": "956-664-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 N 10TH ST",
            "address_2": "SUITE 5",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785043198",
            "telephone_number": "956-664-0240",
            "fax_number": "956-664-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVAREZ",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3517 TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093559503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.